Download hydroxyprogesterone caproate - DavisPlus

Name /bks_53161_deglins_md_disk/hydroxyprogesteronecapro
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(hye-drox-ee-pro-jess-te-rone kap-roe-ate)
Makena
Classification
Therapeutic: hormones
Pharmacologic: progestins
Pregnancy Category B
Indications
Topthe risk of preterm birth in women with a singleton pregnancy who have a history of previous singleton preterm birth.
Action
A synthetic analog of progesterone. Produces secretory changes in the endometrium.
qs basal temperature. Produces changes in the vaginal epithelium. Relaxes uterine
smooth muscle. Stimulates mammary alveolar growth. Inhibits pituitary function. Action in reducing risk of recurrent preterm birth is unknown. Therapeutic Effects:prisk of preterm birth in women at risk.
Pharmacokinetics
Absorption: Slowly absorbed following IM administration.
Distribution: Unknown.
Protein Binding: Extensively bound to plasma proteins.
Metabolism and Excretion: Extensively metabolized by the liver.
Half-life: 7.8 days.
Adverse Reactions/Side Effects
CNS: depression. CV: hypertension. GI: diarrhea, jaundice, nausea. Derm: urticaria, pruritus. F and E: fluid retention. Hemat: THROMBOEMBOLISM. Local: injections site reactions. Misc: allergic reactions including ANGIOEDEMA.
Interactions
Drug-Drug: Mayqmetabolism andpblood levels and effectiveness of drugs metabolized by the CYP1A2, CYP2A6 and CYP2B6 enzyme systems.
Route/Dosage
IM (Adults): 250 mg once weekly starting between 16 wks, 0 days and 20 wks, 6
days continuing until wk 37 of gestation or delivery, whichever occurs first.
NURSING IMPLICATIONS
Assessment
● Monitor for signs and symptoms of thromboembolic disorders through-
out therapy.
● Monitor vital signs during therapy. If hypertension occurs, consider discontinua-
tion of therapy.
● Assess for signs and symptoms of allergic reactions (urticaria, pruritus, angio-
edema) during therapy. Consider discontinuation if allergic reactions occur.
● Monitor for fluid retention during therapy, especially in patients atqrisk for com-
TIME/ACTION PROFILE (blood levels)
ROUTE
ONSET
PEAK
DURATION
IM
unknown
4.6 days
7 days
Contraindications/Precautions
Contraindicated in: Hypersensitivity to hydroxyprogesterone or castor oil; History of or known thrombosis/thromboembolic disorder; History of or known/sus⫽ Genetic Implication.
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pected breast cancer or other hormone-sensitive cancer; Unexplained abnormal
vaginal bleeding unrelated to pregnancy; Cholestatic jaundice of pregnancy; Benign/
malignant liver tumors or active liver disease; Uncontrolled hypertension.
Use Cautiously in: Risk factors for thromboembolic disorders (mayqrisk) ; Diabetes mellitus or risk factors for diabetes mellitus (may impair glucose tolerance);
History of preeclampsia, epilepsy, cardiac or renal impairment (may be adversely affected by fluid retention); History of depression (may worsen); Safe and effective use
in children ⬍16 yr has not been established.
hydroxyprogesterone caproate
⫽ Canadian drug name.
Plate # 0-Composite
plications (preeclampsia, epilepsy, migraine, asthma, cardiac or renal dysfunction).
● Assess mental status and mood changes, especially in women with a history of depression. Discontinue hydroxyprogesterone if depression recurs or worsens.
● Lab Test Considerations: Maypglucose tolerance. Monitor serum glucose in
prediabetic and diabetic women during therapy.
Potential Nursing Diagnoses
Deficient knowledge, related to disease process and medication regimen (Patient/
Family Teaching)
CAPITALS indicate life-threatening, underlines indicate most frequent.
Strikethrough ⫽ Discontinued.
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Implementation
● IM: Draw up 1 mL of solution into a 3 mL syringe with an 18 gauge needle. Solu-
tion is clear, yellow, viscous and oily. Do not administer solutions that are cloudy
or contain particles. Change needle to 21 gauge 1 1/2 inch needle. Inject into upper outer quadrant of gluteus maximus slowly, over 1 min or longer. Apply pressure to injection site to minimize bruising and swelling. Store hydroxyprogesterone in original box, at room temperature, protected from light. Discard unused
product after 5 wks from first use.
Patient/Family Teaching
● Instruct patient to continue to receive injection weekly from health care profes-
sional. If a dose is missed, consult health care professional for instructions regarding returning to schedule.
● Advise patient to notify health care professional if signs and symptoms of blood
clots (leg swelling, redness in your leg, a spot on your leg that is warm to touch, leg
pain that worsens when you bend your foot), allergic reactions (hives, itching,
swelling of the face), depression, or yellowing of skin and whites of the eyes occur.
● Inform patient that injection site reactions (pain, swelling, itching, bruising, nodule formation) may occur. Ifqpain over time, oozing of blood or fluid, or swelling
occur, notify health care professional.
Evaluation/Desired Outcomes
● prisk of preterm birth in women at risk.
Why was this drug prescribed for your patient?
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